And, all of this, to avoid selling a little bit of the narcotic codeine. Which was technically permitted to be sold "behind the counter" without prescription, but was made Schedule II as part of cough syrup in the US not long ago. (It used to be Schedule III or IV when combined with homoatropine or promethazine).

I work for a large agricultural company, in my part of it we sell fertilizer, chemical, and agronomic services. As part of this, we end up putting out a lot of trials so we can actually say something true instead of “buy our stuff it’s great I promise ;)”

One of my favorite slides is when we compiled dozens of trials on something that’s basically a nitrogen fertilizer, which as much of a guaranteed positive effect as you can get in agriculture. When compared in a graph most of the trials show an overwhelming effect on increasing yield over an untreated check, however there’s always a portion of the trials where the yield decreases compared to the (untreated) check.

Real life is extremely noisy for a multitude of circumstantial reasons that are either not practical or possible to control for, so a single trial is generally worth fuckall. It takes a lot of testing to see a consistent trend across them.

DXM may or may not suppress coughing relative to placebo - the study cited here appears to be have been written entirely by authors from drug companies, so perhaps there is some bias. Here's a meta analysis that favors honey over DXM https://pubmed.ncbi.nlm.nih.gov/32817011/, the original study that kicked off this idea that also favors honey https://pubmed.ncbi.nlm.nih.gov/18056558/, and a different meta analysis https://pmc.ncbi.nlm.nih.gov/articles/PMC6513626/ which found little or no difference between honey and DXM. Whether its effective or not, to me there doesn't seem to be compelling evidence that it is more effective than honey.

An interesting new drug is Auvelity, where Dextromethorphan is proposed to help stimulate neurotropic growth factor to help the brain repair itself, and similar related drugs like dextromethorphan and ketamine and other NMDA receptor antagonists are innovative drugs to help prevent Alzheimer's.

> There are so many studies and papers published now that you can find both positive and negative results for just about anything.

Doesn’t that suggest that the effect overall is neutral?

In my subjective experience, Dextromethorphan (DXM, as the robo-trippers call it) does almost nothing for me, in the 1-5% range

The only cold and cough medicine that really truly works is the over-the-counter stuff, pseudoephedrine, works amazing for me. I usually pick up a box of the stuff when school starts in the fall and I go through half a box of it by the following summer.

> ignored all the studies that show honey performing similarly or slightly worse than Dextromethorphan, or studies where honey showed no measurable effect.

To be fair, you're doing pretty much the same by claiming these studies exist without proof.

Are you sure you posted the right paper? That paper appears to present a clinically insignificant outcome for DXM in children.

I think it's perfectly reasonable to contest the research summary this article is providing. All science-based articles on interesting topics are going to be like that. But you're writing your comment as if they took a flyer on DXM, and the research consensus is in fact that DXM is not effective. It's not as bad as phenylephrine (it has detectable, if immaterial, impact in adults), but it's pretty bad.

The point of the article, of course, isn't that Dayquil should be illegal because it's dangerous; it's that it doesn't work. Having spent an unreasonable amount of time in HN pseudoephedrine threads, I think the broad consensus of this site is that phenylephrine should be taken off the shelves.

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